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Overview

Anemia is a condition in which you don’t have enough red blood cells to carry oxygen to the body’s organs and tissues.  This condition can lead to fatigue, weakness, and lightheadedness.

There are many forms of anemia.  Anemia can be temporary or long-term, and it can range from mild to severe.  See your doctor if you suspect you have anemia because it can be a warning sign of serious illness.

Treatments for anemia range from taking iron or vitamin supplements.  You may need laboratory testing and various medical procedures to find the cause of anemia. You may be able to prevent some types of anemia by eating a healthy, varied diet.

Symptoms

Anemia signs and symptoms vary depending on the cause of your anemia. They may include:

  1. Fatigue
  2. Weakness
  3. Pale skin
  4. Shortness of breath
  5. Dizziness or lightheadedness
  6. Chest pain
  7. Cold hands and feet
  8. Headache

Causes

Anemia occurs when your blood doesn’t have enough red blood cells. This can happen if:

  1. Your body doesn’t make enough red blood cells
  2. Bleeding causes you to lose red blood cells more quickly than they can be replaced
  3. Your body destroys red blood cells

Specific Types of anemia and their causes include:

  1. Iron deficiency anemia. This is the most common type of anemia and the most likely reason you will see a gastroenterologist. Iron deficiency anemia is caused by a shortage of iron in your body. Your bone marrow needs iron to make the hemoglobin in red blood cells.  Without iron supplementation, this type of anemia occurs in many pregnant women.  It is also caused by blood loss, such as heavy menstrual bleeding, or losing blood from the gastrointestinal tract.  Losing blood from the gastrointestinal tract may not always show up in your stool.  You can lose microscopic amounts of blood over a period of time that can lead to iron deficiency anemia as well.
  2. Vitamin deficiency anemia. In addition to iron, your body needs folate and vitamin B-12 to produce enough healthy red blood cells. A diet lacking in these and other key nutrients can cause decreased red blood cell production.  Additionally, some people may consume enough B-12, but their bodies aren’t able to process the vitamin. This can lead to vitamin B12 deficiency anemia, also known as pernicious anemia.
  3. Anemia of chronic disease. Certain diseases — such as cancer, HIV/AIDS, rheumatoid arthritis, kidney disease, Crohn’s disease and other chronic inflammatory diseases — can interfere with the production of red blood cells.
  4. Aplastic anemia. This rare, life-threatening anemia occurs when your body doesn’t produce enough red blood cells. Causes of aplastic anemia include infections, certain medicines, autoimmune diseases and exposure to toxic chemicals.
  5. Anemias associated with bone marrow disease. A variety of diseases, such as leukemia and myelofibrosis, can cause anemia by affecting blood production in your bone marrow. The effects of these types of cancer and cancer-like disorders vary from mild to life-threatening.
  6. Hemolytic anemias. This group of anemias develops when red blood cells are destroyed faster than bone marrow can replace them. Certain blood diseases increase red blood cell destruction. You can inherit a hemolytic anemia, or you can develop it later in life.
  7. Sickle cell anemia. This inherited and sometimes serious condition is an inherited hemolytic anemia. It’s caused by a defective form of hemoglobin that forces red blood cells to assume an abnormal crescent (sickle) shape. These irregular blood cells die prematurely, resulting in a chronic shortage of red blood cells.

Diagnosis

To diagnose anemia, your doctor may ask you about your medical and family history, perform a physical exam, and run the following tests:

  1. Complete blood count (CBC). A CBC is used to count the number of blood cells in a sample of your blood. For anemia, your doctor will be interested in the levels of the red blood cells contained in the blood (hematocrit) and the hemoglobin in your blood.  Normal adult hematocrit values vary from one medical practice to another but are generally between 40 and 52 percent for men and 35 and 47 percent for women. Normal adult hemoglobin values are generally 14 to 18 grams per deciliter for men and 12 to 16 grams per deciliter for women.

Additional diagnostic tests

If you receive a diagnosis of anemia, your doctor may order additional tests to determine the underlying cause. For example, iron deficiency anemia can result from chronic bleeding of ulcers, benign polyps in the colon, colon cancer, tumors or kidney problems.

Occasionally, it may be necessary to study a sample of your bone marrow to diagnose anemia.

Treatment

Anemia treatment depends on the cause.

  1. Iron deficiency anemia is the most common form of anemia.  Treatment for this form of anemia usually involves taking iron supplements and making changes to your diet.  If the underlying cause of iron deficiency is the loss of blood — other than from menstruation — the source of the bleeding must be located and stopped. This may involve surgery or gastrointestinal  procedures including upper endoscopy or colonoscopy.
  2. Vitamin deficiency anemias. Treatment for folic acid and B-12 deficiency involves dietary supplements and increasing these nutrients in your diet.  You may also need B-12 shots.
  3. Anemia of chronic disease. There’s no specific treatment for this type of anemia. Doctors focus on treating the underlying disease. If symptoms become severe, a blood transfusion or injections of synthetic erythropoietin, a hormone normally produced by your kidneys, may help stimulate red blood cell production and ease fatigue.
  4. Aplastic anemia. Treatment for this anemia may include blood transfusions to boost levels of red blood cells. You may need a bone marrow transplant if your bone marrow is diseased and can’t make healthy blood cells.
  5. Anemias associated with bone marrow disease. Treatment of these various diseases can include medication, chemotherapy or bone marrow transplantation.
  6. Hemolytic anemias. Managing hemolytic anemias includes avoiding suspect medications, treating related infections and taking drugs that suppress your immune system, which may be attacking your red blood cells.
  7. Sickle cell anemia. Treatment for this anemia may include the administration of oxygen, pain-relieving drugs, and oral and intravenous fluids to reduce pain and prevent complications. Doctors also may recommend blood transfusions, folic acid supplements, and antibiotics.
  8. Thalassemia. This anemia may be treated with blood transfusions, folic acid supplements, medication, removal of the spleen (splenectomy), or a blood and bone marrow stem cell transplant.

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